Gold Coast public hospitals GCUH and Robina could lose accreditation to train young doctors after review

The Gold Coast’s two biggest public hospitals are at risk of losing their accreditation to train young doctors, placing further workload on already stressed frontline services.

THE Gold Coast’s two biggest public hospitals are at risk of losing their accreditation to train young doctors, placing further workload on already stressed frontline services.

A damning report obtained by the Bulletin shows the Gold Coast University and Robina hospitals have until January to sort out concerns around intern overtime, unclear learning objectives, assessment and the confidentiality of performance data.

The Queensland Prevocational Medical Accreditation, a branch of the Medical Board of Australia, has demanded urgent changes in 12 training areas at the hospitals, including the medical assessment units, some palliative care, orthopaedics and vascular.

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Gold Coast University Hospital. Picture Glenn Hampson

Medical groups and staff say the loss of accreditation would affect the work loads of already stressed frontline workers as the 90 interns trained at Gold Coast Hospital and Health Service (GCHHS) each year do most of the grunt work.

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Interns are first-year doctors who do crucial jobs such as assessing patients under the supervision of senior doctors, completing paperwork and organising further treatment.

A Queensland Prevocational Medical Accreditation review last October found “significant governance concerns” and “partial complaints of governance standards” within the training modules at GCHHS. It is understood the review team returned to inspect GCHHS in April and will visit again in October.

Robina Hospital also needs to improve to retain its training accreditation.

The health service scored a D- in a Medical Association Queensland survey of junior doctors late last year, the lowest in the state. The doctors complained of workplace bullying and the fear of mistakes caused by too much overtime and fatigue.

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Dr Philip Morris, the president of the Gold Coast Medical Association, said loss of accreditation in any area would have a “substantial change to the medical manpower of the hospitals”.

“Interns don’t make the big clinical decisions but they make up a lot of the labour,” he said. “Losing any would be an drastic change to workforce of the hospitals, and the workload would escalate for the more senior doctors that remain.

“It is my understanding a one-year review means people are very concerned about the standard and training of junior doctors at the hospital.”

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Dr Philip Morris (President of the Gold Coast Medical Association)

A spokeswoman yesterday said GCHHS was confident it would retain its accreditation and that it was “not uncommon for the accreditation process to apply conditions to internship programs, with a view to continuously improve the learning experience for junior doctors”.

“As a learning organisation, Gold Coast Health welcomes this process as an opportunity to improve our junior doctor training, and we’re confident we have met (or will meet) all the requirements.

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“The wellbeing of our junior doctors is a priority, and we will continue to collaborate with PMAQ to prioritise the professional development of Gold Coast interns.”

A number of hospital employees told the Bulletin this week of the frustration felt by young doctors.

“They spoke of long hours and confusion as to what is required of them in some units in order to complete their qualifications,” one staff member said.

An intern said: “We are working hard, but we need the right feedback. The process just doesn’t feel structured.

“There is a lot of work to get the training up to scratch, but it feels like we have hit a brick wall and nothing is happening.”

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Dr Marco Giuseppin, the deputy chair of AMA Queensland Council of Doctors in Training, said it was not uncommon for accreditation terms to be reduced. However, it was uncommon for hospitals to be issued with a one-year accreditation.

“AMA Queensland would be concerned if this causes uncertainty amongst medical students looking to apply for internships on the Gold Coast Hospital next year,” he said.

The GCHHS’s training capacity was given accreditation for four years in 2014. However, it was extended by only 12 months when reviewed last year.

“The one-year accreditation … is a result of concerns with the overarching governance of the program and subsequent partial compliance with a number of governance standards and domains,” the report read.

“Clinical governance was also lacking with the responsibility and accountability for medical practice of internal and prevocational doctors remaining unclear. Quality assurance, improvement and monitoring and evaluation processes were inconsistent and incomplete.”